Journal article

Multifactorial Chromosomal Variants Regulate Polymyxin Resistance in Extensively Drug-Resistant Klebsiella pneumoniae

Miranda Pitt, Alysha Elliott, Minh Duc Cao, Devika Ganesamoorthy, Ilias Karaiskos, Helen Giamarellou, Cely Abboud, Mark AT Blaskovich, Matthew Cooper, Lachlan Coin

Published : 2017


ABSTRACT Extensively drug-resistant Klebsiella pneumoniae (XDR-KP) infections cause high mortality and are disseminating globally. Identifying the genetic basis underpinning resistance allows for rapid diagnosis and treatment. XDR isolates sourced from Greece and Brazil, including nineteen polymyxin-resistant and five polymyxin-susceptible strains, underwent whole genome sequencing. Approximately 90% of polymyxin resistance was enabled by alterations upstream or within mgrB . The most common mutation identified was an insertion at nucleotide position 75 in mgrB via an ISK pn26 -like element in the ST258 lineage and ISK pn13 in one ST11 isolate. Three strains acquired an IS1 element upstream ..

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